Shawn Holloway, R.A.S.

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Taft, CA

NPI 1194004002 · NPPES record last updated Aug 9, 2011

Key facts

NPI
1194004002
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
H0608122153 (CA)
Practice address
1021 4TH St
Taft, CA 93268-2433
Phone
(661) 765-7025
Fax
(661) 765-7045
NPI assigned
Aug 9, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
H0608122153CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
College Community Services Past
since Jul 31, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X H0608122153 CA Yes

Addresses

Primary practice location

1021 4TH St
Taft, CA 93268-2433

Mailing address

37 La Mesa Dr
Bakersfield, CA 93305-2919

Other providers in Taft, CA

All providers in Taft, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.